Highlights for digoxin

Digoxin is used to treat atrial fibrillation, mild to moderate heart failure in adults, and heart failure in children.

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Your dose will be based on your weight, age, kidney function, other conditions you have, and other drugs you take. You may start with a larger loading dose and then reduce your dose to a maintenance dose.

Risk of overdose in children

If your child is taking
digoxin, make sure you’re aware of the symptoms of overdose in children. These
include weight loss, failure to thrive, stomach pain, and behavioral changes.

What is digoxin?

Digoxin is a prescription
drug. It’s available in these forms: oral tablet and oral solution.

Digoxin is available
in its generic form. Generic drugs usually cost less. In some cases they may
not be available in every strength or form as the brand. Talk to your healthcare provider to see if
the generic will work for you.

Why it's used

Digoxin is used to treat heart rhythm problems and heart
failure. It increases the strength of your heart muscle, normalizes heart
rhythm, and helps remove excess water from your body.

How it works

Digoxin belongs to a
class of drugs called antiarrhythmics. It works by affecting the sodium pump in
your body.

How It Works

Digoxin belongs to a
class of drugs called antiarrhythmics. It works by affecting the sodium pump in
your body. Digoxin blocks the sodium pump, which causes sodium to move out of
the cells and potassium to move into cells. This affects your heart rhythm,
increases your heart strength, and removes excess water from your body.

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SECTION 2 of 5

digoxin Side Effects

Oral solution

Most Common Side Effects

The most common side effects that occur with digoxin
include:

breast enlargement

diarrhea

Serious Side Effects

If you experience
any of these serious side effects, call your doctor right away. If your
symptoms are potentially life threatening or if you think you’re experiencing a
medical emergency, call 9-1-1.

Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

Digoxin does not cause drowsiness.

Mild
side effects may go away within a few days or a couple of weeks. Talk to your
doctor or pharmacist if they’re more severe or don’t go away.

Disclaimer:
Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

SECTION 3 of 5

digoxin May Interact with Other Medications

Oral solution

Digoxin may interact
with other medications, herbs, or vitamins you might be taking. That’s why your
doctor should manage all of your medications carefully. If you’re curious about
how this drug might interact with something else you’re taking, talk to your
doctor or pharmacist.

Note: You can reduce the chances of drug interactions by
having all of your prescriptions filled at the same pharmacy. That way, a
pharmacist can check for possible drug interactions.

Medications That Might Interact with This Drug

Heart rhythm drugs

amiodarone

quinidine

dofetilide

dronedarone

propafenone

These drugs may
increase the levels of digoxin in your body. This can lead to toxicity and more
side effects, such as heart problems. Your doctor may adjust your dose of
digoxin if you have to take these medicines together.

HIV medications

atazanavir/cobicistat (Evotaz)

darunavir/cobicistat (Prezcobix)

ritonavir (Norvir)

saquinavir (Invirase)

lopinavir/ritonavir (Kaletra)

These medicines
increase the level of digoxin in your body. This could result in more side
effects or toxicity. Your doctor may lower your dose of digoxin before starting
these medications.

Blood pressure drugs

captopril

carvedilol

diltiazem

verapamil

nifedipine

spironolactone

telmisartan

These drugs increase
the levels of digoxin in your body. Your digoxin levels will be monitored and
your dose may be reduced before you start taking these blood pressure
medicines.

Antibiotics

clarithromycin

erythromycin

gentamicin

trimethoprim

tetracyclines

These medications
increase digoxin levels in your body. Your digoxin levels will be monitored and
your dose may need to be reduced.

Lung cancer drug

crizotinib

Crizotinib increases
digoxin levels in your body and can cause lower than normal heart rate. You
will need to be monitored for digoxin toxicity if you take these medications
together.

Immune suppressing drug

cyclosporine

Cyclosporine
increases digoxin levels in your body. Your digoxin levels will be monitored
and your dose may need to be reduced.

Cholesterol drug

atorvastatin

Atorvastatin
increases digoxin levels in your body. Your digoxin levels will be monitored
and your dose may need to be reduced.

Antifungal drug

itraconazole

Itraconazole increases digoxin levels in your body. Your
digoxin levels will be monitored and your dose may need to be reduced.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Examples are:

indomethacin

ibuprofen

naproxen

NSAIDs increase
digoxin levels in your body. Your digoxin levels will be monitored and your
dose may need to be reduced.

Antidepressant

nefazodone

Nefazodone increases digoxin levels in your body. Your
digoxin levels will be monitored and your dose may need to be reduced.

Leukemia drug

nilotinib

Nilotinib increases digoxin levels in your body. Your
digoxin levels will be monitored and your dose may need to be reduced.

Propantheline

Propantheline increases digoxin levels in your body. Your
digoxin levels will be monitored and your dose may need to be reduced.

Antimalarial

quinine

Quinine increases
digoxin levels in your body. Your digoxin levels will be monitored and your
dose may need to be reduced.

Chest pain drug

ranolazine

Ranolazine increases
digoxin levels in your body. Your digoxin levels will be monitored and your
dose may need to be reduced. Your digoxin levels will need to be monitored and
your dose of digoxin may need to be reduced before starting ranolazine.

Succinylcholine

Taking succinylcholine with digoxin it can lead to irregular
heart rhythm.

Stimulant drugs

Examples are:

epinephrine

norepinephrine

phenylephrine

If you take these medications with digoxin, it can lead to
irregular heart rhythm.

Low sodium level drug

tolvaptan

Tolvaptan increases digoxin levels in your body. Your
digoxin levels will be monitored and your dose may need to be reduced.

Disclaimer:
Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

Digoxin Warnings

People with heart problems

People with
ventricular fibrillation: Digoxin
can’t be used if you have ventricular fibrillation. It may
make your ventricular fibrillation worse.

People with Wolff-Parkinson-White
syndrome: If you have Wolff-Parkinson-White
syndrome, you’re at a higher risk for an abnormal heart rhythm. Digoxin may
increase your risk even further.

People with sinus node
disease and AV block:
Digoxin can cause severe low heart rate and complete heart block if you have
sinus node disease. You should get a pacemaker before starting digoxin if you
have sinus node disease or heart block.

People with preserved
left ventricular systolic function: If you have this type of heart failure you should not use
digoxin. It may increase your risk of side effects, such as chest pain and
shortness of breath.

People with a risk of
ventricular arrhythmias during electrical cardioversion: If you’re going to receive electrical
cardioversion, your dose of digoxin may be reduced or you may be taken off of
the medication 1–2 days before your procedure. This is done to prevent heart
rhythm problems.

People with a history
of a heart attack: Digoxin
isn’t recommended for people with a history of a heart attack. Using this drug
can restrict blood flow to the heart.

People with myocarditis: You shouldn’t use digoxin if you have
myocarditis. It can narrow your blood vessels and cause inflammation.

People with kidney disease

Digoxin is cleared
from your body by your kidneys. If your kidneys don’t work as well, the drug
may build up and cause toxicity. Your dose should be lower than normal if you
have kidney problems.

People with thyroid disorders

If you have hypothyroidism
you might be more sensitive to digoxin. Because of this, your dose of digoxin
may need to be reduced.

People with electrolyte imbalances

If you have low levels of
potassium, digoxin may be more active in your body, increasing the risk for
toxicity. If you have low levels of magnesium, your heart may be more sensitive
to changes in heart rhythm due to digoxin. If you have high levels of calcium,
digoxin will cause more calcium to enter your body’s cells, which can make you
more sensitive to changes in heart rhythm. You may be more likely to get
digoxin toxicity, even at normal digoxin levels, if you have any of these
electrolyte imbalances.

Pregnant women

Digoxin is a
category C pregnancy drug. That means two things:

Research in animals has shown adverse
effects to the fetus when the mother takes the drug.

There haven’t been enough studies done in
humans to be certain how the drug might affect the fetus.

Tell
your doctor if you’re pregnant or plan to become pregnant. Digoxin should be
used during pregnancy only if the potential benefit justifies the potential
risk to the fetus.

Women who are nursing

Studies have shown that digoxin passes through breast milk.
It’s unknown if this causes any effects in a breastfeeding child.

You and your doctor may need to decide if you’ll take digoxin or
breastfeed.

For Seniors

Seniors may need
smaller doses of digoxin and may be monitored more closely. Adults over 65 years
old are more likely to have kidney problems, which may lead to greater drug side
effects.

For Children

The safety and
effectiveness of digoxin in people under 18 years hasn’t been established. But the
drug may be used to treat heart failure in children.

Allergies

This drug may cause a severe allergic reaction. Symptoms may
include:

skin
rash

hives

itching

swelling
of your face, lips, or tongue

Don’t take this drug again if you’ve ever had an
allergic reaction to it. Taking it again could be fatal.

SECTION 4 of 5

How to Take digoxin (Dosage)

Oral solution

All possible dosages
and forms may not be included here. Your dose, form, and how often you take it
will depend on:

your age

the condition being treated

how severe your condition is

other medical conditions you have

how you react to the first dose

What Are You Taking This Medication For?

Mild to moderate heart failure in adults

Form: Oral solution

Strengths: 50 mcg/mL

Adult Dosage (ages 18 years and older)

Digoxin solution is only used in adults
with a very low body weight.

Loading Dose: If a loading dose is
needed, half of the loading dose is given first.

Your doctor will monitor you closely
before giving any additional doses.

The dose is specific for each person.

Maintenance Dose: Your dose will be
individualized. You’ll take it once per day.

Special Considerations

Kidney disease: Digoxin is cleared from your body by your kidneys. If you have kidney disease, your dose of digoxin will be lower.

Thyroid disorders: If you have hypothyroidism, you might be more sensitive to digoxin. Because of this, your dose of digoxin may need to be reduced.

Warnings

Toxic levels of digoxin are only slightly higher than therapeutic levels. Dosing can be started with a larger loading dose and followed by a reduced maintenance dose, or it can just be started with a maintenance dose.

Atrial fibrillation in adults

Form: Oral solution

Strengths: 50 mcg/mL

Adult Dosage (ages 18 years and older)

Digoxin solution is only used in adults
with a very low body weight.

Loading Dose: If a loading dose is
needed, half of the loading dose is given first.

Your doctor will monitor you closely
before giving any additional doses.

The dose is specific for each person.

Maintenance Dose: Your dose will be
individualized. You’ll take it once per day.

Special Considerations

Kidney disease: Digoxin is cleared from your body by your kidneys. If you have kidney disease, your dose of digoxin will be lower.

Thyroid disorders: If you have hypothyroidism, you might be more sensitive to digoxin. Because of this, your dose of digoxin may need to be reduced.

Warnings

Toxic levels of digoxin are only slightly higher than therapeutic levels. Dosing can be started with a larger loading dose and followed by a reduced maintenance dose, or it can just be started with a maintenance dose.

Heart failure in children

Form: Oral solution

Strengths: 50 mcg/mL

Child Dosage (ages 11-17 years)

Loading Dose: The dose is based on your
age. If a loading dose is needed, half of the loading dose is given first.

Your doctor will monitor you closely
before giving any additional doses. The dose is specific for each person.

Maintenance Dose: Your dose will be
individualized and taken once per day. You will be given an adult dose that is
proportional to your weight.

Child Dosage (ages 0-10 years)

Loading Dose: The dose is based on your
age. For infants, it’s based on if they were born prematurely or were full term.

If a loading dose is needed, half of
the loading dose is given first.

Your doctor will monitor you closely
before giving any additional doses. The dose is specific for each person.

Maintenance Dose: Your dose will be
individualized. It will be given twice per day.

Special Considerations

Kidney disease: Digoxin is cleared from your body by your kidneys. If you have kidney disease, your dose of digoxin will be lower.

Thyroid disorders: If you have hypothyroidism, you might be more sensitive to digoxin. Because of this, your dose of digoxin may need to be reduced.

Warnings

Toxic levels of digoxin are only slightly higher than therapeutic levels. Dosing can be started with a larger loading dose and followed by a reduced maintenance dose, or it can just be started with a maintenance dose.

Disclaimer:
Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.

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Disclaimer:
Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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